Needed to read PDF's

Adobe Reader |
Radiculopathy
Radiculopathy can cause pain, numbness and tingling along a
pinched nerve in your back. There are three types of
radiculopathy — cervical, thoracic and lumbar. Which type you
have depends on where in your back your pinched nerve is.
What is radiculopathy?
Radiculopathy is caused by a pinched nerve in your spine.
More specifically, it happens when one of your nerve roots
(where your nerves join your spinal column) is compressed or
irritated. You might see it referred to as radiculitis.
Radiculopathy will cause the area around your pinched nerve
to feel painful, numb or tingly.
Depending on where along your spine the
pinched nerve is, your healthcare provider will classify
the radiculopathy as one of three types:
- Cervical radiculopathy (neck).
- Thoracic radiculopathy (upper middle back).
- Lumbar radiculopathy (low back).
Usually improving your posture, over-the-counter medicine or
at-home physical therapy exercises are the only treatments
you’ll need to relieve radiculopathy symptoms. In fact, some
cases of radiculopathy improve with no treatment at all.
Radiculopathy vs. myelopathy
Both radiculopathy and myelopathy are painful conditions
involving your spine. Radiculopathy is a temporary issue
caused by a pinched nerve root near your spine. Myelopathy is compression of your spinal cord caused by
a trauma, tumor, degenerative disease or infection.
If it’s not treated, myelopathy can worsen over time and
cause permanent damage to your nerves. Radiculopathy is a
temporary issue that heals over time and often goes away
without treatment.
It can be hard to tell what’s causing your pain. That’s why
it’s important to talk to your healthcare provider as soon
as you notice any new symptoms — especially if they last
more than a few days.
Radiculopathy vs. spondylolysis
Spondylolysis is a weakness at the point your vertebrae
(the bones that make up your spine) connect together. This
can lead to small stress fractures that cause pain, usually in your lower
back. It usually affects teens going through growth spurts.
Radiculopathy can be caused by bones in your spine moving
out of place, but symptoms like pain are caused when your
nerve roots are compressed or irritated, and not by a broken
bone.
Radiculopathy vs. sciatica
Both radiculopathy and sciatica are caused by pinched
nerves.
The difference is which nerves are pinched causing the pain.
Radiculopathy happens when a nerve along your spine is
irritated or compressed. Sciatica is the pain or discomfort you feel when your
sciatic nerve — the longest nerve in your body that starts
in your lower back and runs down the back of each of your
legs — gets compressed or pinched.
Radiculopathy usually hurts in the area of your back near
the pinched nerve. Sciatica is a type of radiculopathy that
causes pain along your sciatic nerve in your lower back and
down your legs.
Who does radiculopathy affect?
Men are somewhat more likely than women to develop lumbar
radiculopathy, and the average age at the time of disc surgery
is 40. Driving vocations, frequent lifting, twisting motions,
heavy industry labor, back injuries, higher height, smoking,
overweight, sedentary lifestyle, numerous pregnancies, back pain
history, and chronic cough are all risk factors. This includes
bulging discs, spinal stenosis, or injury to the spine. Often a
patient may “overdo” a certain strenuous activity, such as
gardening or lifting boxes
How common is radiculopathy?
Radiculopathy is rare. While neck pain and back pain —
especially lower back pain — are common problems, they’re rarely
caused by radiculopathy.
How does radiculopathy affect my body?
The most obvious way radiculopathy affects your body is the
pain and other symptoms it causes around your pinched nerve.
Depending on how severe your symptoms are — and which type
of radiculopathy you have — it might be hard or
uncomfortable to sit, stand or move. For example, if you
have cervical radiculopathy, it might be painful and
difficult to move your neck.
Symptoms of radiculopathy
What are radiculopathy symptoms?
Symptoms of radiculopathy include:
- Pain. For cervical radiculopathies, the pain often
radiates from the neck and down the arm (sometimes to the
shoulder/scapula). For lumbar and lumbosacral
radiculopathies, the pain radiates from the low back down
the buttock and leg.
- Numbness or tingling. These sensory changes may be
present in the arm/hand or leg/foot.
- Weakness. For a cervical radiculopathy, you may have
weakness in your arm/hand and notice that you drop things or
have difficulty lifting things. For a lumbar radiculopathy,
you may have weakness in your leg/foot and notice that you
have trouble walking and catch your toe on things.
- Bladder or bowel changes. Less commonly, the nerves
affecting the bladder and bowel can become compressed and
contribute to loss of control and incontinence of bladder or
bowel function.
Where you experience symptoms depends on which type of
radiculopathy you have.
-
Cervical radiculopathy: You might have
pain and other symptoms in and around your neck, but
these symptoms can radiate (spread out) to your arms and
hands, too.
-
Thoracic radiculopathy: You’ll likely
have pain in and around your chest, including when you
breathe in and out.
-
Lumbar radiculopathy: The pain or
numbness in your lower back can spread to your legs.
Some radiculopathy symptoms are similar to other, much more
serious issues. Don’t ignore pain in your chest, trouble
breathing or numbness in your limbs. Talk to your healthcare
provider as soon as you notice these symptoms.
What causes radiculopathy?
Radiculopathy is caused by impingement of a spinal nerve root.
The most common cause of compression is a disc herniation and/or
degenerative changes in the spine. Spondylolisthesis (when a
vertebra is out of alignment relative to the adjacent vertebra)
may also contribute. Less common causes of nerve compression
include cyst, fracture, infection, and tumor.
Anything that compresses or irritates the roots of your
spinal nerves can cause radiculopathy, including:
- Traumas like falls or car accidents.
- Bone spurs growing on one of your vertebrae.
- A
herniated disc (also referred to as slipped,
ruptured or bulging discs).
You can also develop radiculopathy with no direct cause
other than getting older. As you age, your bones and the
discs in your spine lose their shape and flexibility. This
natural degeneration and weakening can cause your spine to
shift enough to pinch a nerve.
Diagnosis and Tests
How is radiculopathy diagnosed?
Your healthcare provider will diagnose radiculopathy with a
physical exam and imaging tests. They’ll look at your back
and spine, talk to you about your symptoms and ask about the
different sensations you’re feeling.
You’ll probably need at least one of a few imaging tests,
including:
-
X-ray: An X-ray can show narrowing
and changing alignment of your spinal cord, as well as
any spinal fractures.
-
Computed tomography (CT) scan: A CT
scan shows 3D images and more detail of your spine than
an X-ray can.
-
Magnetic resonance imaging (MRI):
An MRI can show if damage to soft tissues is causing the
nerve compression. It will also show any damage to your
spinal cord.
-
Electromyography (EMG): An EMG
measures electrical impulses in your muscles. This can
help determine if a nerve is working as it should. This
helps your healthcare provider know if your symptoms are
caused by pressure on your spinal nerve roots or if
another condition (like diabetes) damaged your nerves.
Management and Treatment
How is radiculopathy treated?
Treatment depends on which type of radiculopathy you have (where the
pinched nerve is along your spine) and how severe your symptoms are.
Some people never need formal treatment if their symptoms improve on
their own in a few days or weeks.
If you do need treatment, it might include some or all of the following:
-
Ice or heat: Your healthcare provider will tell you
how often to ice or apply heat to your back to reduce swelling or
relax tight muscles.
-
Adjusting your posture or physical therapy:
Stretches and exercises that target the area around your spine can
help ease pressure on your nerves and relieve pain. Improving your
overall posture can help reduce stress on your spine and relieve
your symptoms. Your healthcare provider or physical therapist will
advise you on which types of exercises are best for the type of
radiculopathy you have.
What medications are used to treat radiculopathy?
-
Over-the-counter NSAIDs: Most people only need
over-the-counter
NSAIDs (like aspirin or ibuprofen) to treat their radiculopathy
symptoms. Talk to your healthcare provider before taking an NSAID
for longer than 10 days.
-
Corticosteroids:Your healthcare provider might
prescribe strong anti-inflammatory medications like prednisone to
relieve your pain. These can be taken as pills or injected directly
into the affected area of your back.
Radiculopathy surgery
It’s rare to need surgery to treat radiculopathy. Your healthcare
provider will likely only recommend surgery if you have severe symptoms
that affect your quality of life and don’t respond to other treatments.
They’ll tell you which type of surgery you’ll need and what to expect.
How do I manage my radiculopathy symptoms?
Talk to your healthcare provider or physical therapist about how you can
adjust your posture to make your daily routine more comfortable. They’ll
recommend how you can comfortably sit, stand and sleep without
aggravating your radiculopathy.
If your healthcare provider or physical therapist shows you stretches or
exercises to strengthen your core muscles, try to do them as often as
they recommend.
Don’t force yourself to do anything that hurts while you’re recovering,
though. It might make your symptoms worse. Talk to your healthcare
provider or physical therapist if the exercises they provide you are
painful. They’ll tell you how to work through them safely.
How soon after treatment will I feel better?
You should feel better over time as you start treating radiculopathy
symptoms. Some people feel better in a few days, but sometimes it takes
a few weeks.
Outlook / Prognosis
What can I expect if I have radiculopathy?
You should expect to make a full recovery from an episode of
radiculopathy. It can be very painful and inconvenient, but
it’s usually a temporary condition.
How long does radiculopathy last?
It depends on what caused your radiculopathy, and which type
you’re experiencing. In general, most people feel better in
a few weeks (or sooner). It might be longer if you have
severe symptoms or other conditions that affect your spine.
Will I have to miss work or school?
If you can do your job or schoolwork without aggravating
your symptoms, you shouldn’t have to miss work or school
while you’re recovering from radiculopathy. Talk to your
healthcare provider before resuming any physical activities.
Prevention
How can I prevent radiculopathy?
Many of the causes of radiculopathy can’t be prevented. Maintaining good
spine health and posture can help prevent some of the degeneration
that can lead to radiculopathy.
Some causes of lumbar radiculopathy, like age-related
degeneration, may be outside of your control. The most common
cause of lumbar radiculopathy is a herniated disc. You may be to
lower your odds of a herniated disc by:
- lifting weights with good technique and not heavier than
your capabilities
- maintaining a healthy weight
- breaking up periods of prolonged sitting
- avoiding smoking, which may increase disc degeneration
- avoiding twisting when lifting heavy objects
- exercising regularly
Living With
When should I see my healthcare provider?
Talk to your healthcare provider if you develop new symptoms
in your back or along your spine, especially if they’re
getting worse over a few days. Lots of issues can have
similar symptoms, so it’s important to visit your healthcare
provider right away. They’ll make sure you don’t have a more
serious condition or injury.
When should I go to ER?
Go to the emergency room right away if you’ve experienced a
trauma or you can’t move your hands, arms, legs or neck the
way you usually can.
What questions should I ask my doctor?
- What type of radiculopathy do I have?
- Which treatments will I need?
- How long will it take to heal?
- What imaging tests will I need?
One Final Note..
Almost everyone experiences back pain at some point in their lives.
There’s a difference between occasional aches and pains and a
painful condition like radiculopathy, though. It can be scary to
hear that something is wrong near your spine, but all forms of
radiculopathy are very treatable and very rarely require surgery.
You should make a full recovery with at-home treatments and by
giving your body time to heal.
Lumbar radiculopathy is pain and other neurological symptoms
caused by pressure on a nerve root in your lower back. It
may cause shooting pain down the back of your leg and other
symptoms like weakness or tingling.
Most cases of lumbar radiculopathy heal with conservative
treatment. If conservative treatment options don’t ease your
symptoms, your doctor may recommend surgery.
|